Proper Use

Drug information provided by: Micromedex

Use this medicine only as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered.

The Abstral®, Actiq®, Fentora®, Onsolis®, and Subsys® products are only available under a restricted distribution program. You will have to read and sign papers that explain how the medicine is used when you pick up your prescription.

This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions. Ask your pharmacist for the Medication Guide if you do not have one.

Use only the brand of this medicine that your doctor prescribed. Different brands may not work the same way.

Keep the medicine in the original blister package. Open the package right before use.

Abstral® tablets:

  • Place the tablet under the tongue until it dissolves. Do not chew, suck, or swallow the tablet.
  • Do not eat or drink anything until the tablet has dissolved. If your mouth is dry, use water to rinse the mouth before you place the tablet under the tongue.

Actiq® lozenges:

  • Place the lozenge in the mouth between the cheek and lower gum. Using the handle, move the lozenge from one side to the other every now and then.
  • Suck the medicine for 15 minutes and do not chew it.

Fentora® buccal tablets:

  • Peel the blister back to remove the tablet. Do not push the tablet through the blister as this may damage the tablet.
  • Place the tablet between the upper cheek and gum, above a back molar, until it dissolves. Do not chew, suck, or swallow the tablet.
  • If the tablet does not dissolve completely after 30 minutes, you may swallow it with a glass of water.

Onsolis® buccal film:

  • Use your tongue to wet the side of your cheek or rinse your mouth with water in the area where you will place the film.
  • Do not cut or tear the film. Hold the film on a clean, dry finger with the pink side facing up.
  • Press the film against your cheek and hold it there for 5 seconds.
  • Leave the film in place until it dissolves and do not touch or move the film. Do not chew or swallow the film.
  • If you must use more than one film, place the second film on the other side of your mouth.
  • Do not eat any food until the film dissolves. You may drink water or other liquids after 5 minutes.

Subsys® sublingual spray:

  • Carefully spray the medicine under your tongue.
  • Hold the medicine under your tongue for 30 to 60 seconds. Do not rinse your mouth and do not spit out any medicine.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For cancer pain:
    • For buccal dosage form (film):
      • Adults—At first, one 200 microgram (mcg) film for each pain episode. Your doctor may adjust your dose as needed. However, the maximum number of pain episodes that can be treated each day is 4.
      • Children—Use and dose must be determined by your doctor.
    • For buccal dosage form (tablets):
      • Adults—At first, 100 micrograms (mcg) for each pain episode. If instructed by your doctor, this dose may be repeated after waiting 30 minutes between doses. Your doctor may adjust your dose as needed. However, the maximum number of pain episodes that can be treated each day is 4.
      • Children—Use and dose must be determined by your doctor.
    • For transmucosal dosage form (lozenges):
      • Adults—At first, 200 micrograms (mcg) for each pain episode. If instructed by your doctor, this dose may be repeated after waiting 15 minutes between doses. Your doctor may adjust your dose as needed. However, the maximum number of units that can be used each day is 4.
      • Children—Use and dose must be determined by your doctor.
    • For sublingual dosage form (spray):
      • Adults—At first, 100 micrograms (mcg) or 1 spray for each pain episode. If instructed by your doctor, this dose may be repeated once after waiting 30 minutes. Additional pain episodes may be treated after a minimum of 4 hours.
      • Children—Use and dose must be determined by your doctor.
    • For sublingual dosage form (tablets):
      • Adults—At first, 100 micrograms (mcg) for each pain episode. If instructed by your doctor, this dose may be repeated after waiting 30 minutes between doses. Your doctor may adjust your dose as needed. However, the maximum number of pain episodes that can be treated each day is 4.
      • Children—Use and dose must be determined by your doctor.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Abstral® tablets: Dispose of any unopened tablets that are not needed. Remove the tablets from the blister package and flush them down the toilet. Do not flush the blister package or carton down the toilet. If you have questions, call 1-888-227-8725.

Actiq® lozenges: Place used handles in the temporary storage bottle from the Actiq® Child Safety Kit and empty the bottle each day. To dispose of the lozenge end of the handle, hold it over the toilet and cut it off with wire-cutting pliers. Flush the toilet twice. Throw the handle away in a place that is out of the reach of children. Use the same process to dispose of any unopened lozenges, but only flush 5 lozenges at a time. Do not flush the entire lozenge unit, the handle, or the blister package down the toilet. If you have questions, call 1-800-896-5855.

Fentora® tablets: Dispose of any unopened tablets that are not needed. Remove the tablets from the blister package and flush them down the toilet. Do not flush the blister package or carton down the toilet. If you have questions, call 1-800-896-5855.

Onsolis® film: Dispose of any unopened film that is not needed. Remove the film from the foil package and flush it down the toilet. Do not flush the foil package or carton down the toilet. If you have questions, call 1-800-526-3840.

Subsys® spray: Place the used spray unit into a disposal bag. Seal the disposal bag and throw it into a trash container that is out of the reach of children. For the unopened spray units, use the disposal bottle to empty the liquid from each unit. Place the disposal bottle in a bag and seal it. Throw the bag into a trash container that is out of the reach of children. If you have questions, call 1-877-978-2797.